Resources and Forms II | Antioch Charter Academies

Resources & Forms

Resources and Forms

LCAP (Local Control Accountability Plan) 2021-2022

School Accountability Report Card (SARC)

COVID-19 Operations Written Report

Comprehensive Schoolwide Safety Plan

California School Dashboard

CAASPP State Test Results

EPA Spending Summary

Guidelines for School Closures

Report of Health Exam form

Oral Health Assessment form

California Immunization Requirements

Chaperone Driver Information form

Student-Parent-School Agreement

Special Education Procedural Safeguards (Parent Rights)

Traffic Flow Diagram

Traffic Flow Agreement

Uniform Complaint Procedure Form

CHAPERONE AND DRIVER INFO FOR
Name*
First Last
Student(s) Name(s)
All names on this list will be checked against the Megan’s Law Website to be sure that all our volunteers are legally able to be around children under the age of 18. Please have all parents/adults who may wish to chaperone on any of the study trips for this school year read the study trip policy and provide the information in the spaces below. Also, please let the teachers know if at anytime during the school year you wish to add or remove someone from this list.
Name*
First Last
Phone*
Address*
Street Address City State ZIP Code
Signature*
Date*
MM slash DD slash YYYY
Upload your required documents here
Drop files here or
Max. file size: 256 MB.
Please upload a scan/ copy of the following: -Your automobile insurance -Your DMV driver record
PLEASE INITIAL EACH STATEMENT BELOW
Your Initial*
I have read the Antioch Charter Academy Driver/Chaperone Policies. I understand that it is important as a chaperone to follow these steps and I am agreeing to do so as a study trip volunteer.
Your Initial*
I have enclosed a copy of my automobile insurance to show that I have a minimum of $100,000/$300,000 per occurrence in car insurance, should I choose to drive students in my car during the school year. If my automobile insurance is terminated I will immediately cease transporting Antioch Charter Academy students for school sponsored activities and events.
Your Initial*
I have enclosed a copy of my DMV driver record.
Which Academy will you be driving for? (select all that apply)*
- ACA
- ACA II

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Antioch Charter Academy II

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1201 W. 10th St., Antioch, CA

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(925) 755-1252

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